The relationship between mental health and the law

Where are our safe spaces?

We hear about the need for ‘trauma informed care’ in mental health constantly, yet it appears that trauma is being totally ignored; as if by refusing to take notice of or acknowledge it, maybe it will just go. If only. If only I could erase the trauma we have been through. If only I could erase everyone’s trauma. Nobody should have to suffer with constant flashbacks, sleepless nights or anxiety just going out the front door.

After blogging about my experience of sexual assault that had taken place on a mental health ward in 2016, I received a huge number of messages from others who have been through very similar situations. It shocked me to think how common this is. Patients are experiencing degradation, humiliation and threatening behaviour from those of the opposite sex on a daily basis on wards in the UK. There are a huge amount of people who have previously been sexually assaulted, yet when needing help for the trauma, are then placed on a mixed-sex ward. This is not just counterproductive, it is unsafe and dangerous.

Two months ago, I was placed on a mixed-sex ward by the Bed Management Team of Barnet Enfield and Haringey Mental Health Trust. This short stay was the reason behind my starting a government petition against these wards. The Petition can be signed here: https://petition.parliament.uk/petitions/260312 Note to those in bed management – mixed wards arenever places of safety.

I have had a couple of discussions with those stating that my campaign is not a good idea. One was a statement I have only heard from professionals in the field that ‘female-only wards have a higher rate of violence’. I have seen no actual statistical proof of this as yet, and I also have various theories why such data may be skewed. The other comment I received was that ‘in the real world we have to mix’. Well, we aren’t talking about the real world? There are 16 acute female beds in the entire Borough of Barnet, which in 2017 had 384,000+ inhabitants! There are 8 beds on Trent ward and 8 on Thames. Barnet is the highest populated London Borough yet they can only offer 16 acute mental health beds for females. The lack of beds thus impacts on the severity of those admitted to such wards. To be admitted to a ward you will need to be considered extremely high risk; if you are ‘just suicidal’ (not my words!) they will try keep you safe at home with the Crisis Creation Team (discussed here!). In the real world you aren’t seriously unwell and stuck in a very small space with a huge amount of seriously unwell men.

During my time on Trent Ward, I couldn’t leave my bedroom to get food or water. I had no way of even asking for help from the nurses or seeing visitors unless I went through a mixed-sex area. The ward round room was down a male corridor. The female corridor was the one used to access the garden and so at certain times of the day the corridor was full of men. There was a 3:1 ratio of male to female patients on the ward and add to that another 11 or so staff members, many of whom were male too. One male patient spent half his time running up the female corridor. Females were expected to sit in the lounge or dining room alongside men who were very unwell and sometimes sexually uninhibited. The one quiet room on the ward was often locked, was taken up by staff, and on one occasion when I was sitting in there trying to watch TV and do some writing, was intruded upon by a staff member taking her break. She put her (bare) feet up on the chair next to me and started having a loud conversation with a family member about freezers. I left the room. Staff have the ability to leave the [locked] ward doors without a problem; yet I who could go nowhere had to leave the one room considered safe.

When on the ward, I attempted to live Tweet about the negative conditions I was being kept in and how the mixed-sex environment was causing me huge stress. On the second night after I had been admitted, 7 staff members charged in and tried to take my phone away threatening force to remove it from me. The (male) lead nurse on that night kept saying I was breaking the law for Tweeting! After an extremely distressing shouting match, I somehow managed to get them out of the room without them taking my phone (only when a staff member stated she was worried that I was recording the whole episode – oh how I wish I had). After this altercation and my fear of being assaulted by staff in order for them to remove my phone from me, I went back and deleted all my Tweets. I was absolutely petrified of having the only thing that kept me safe taken away. I look back and I regret the deletion of the tweets. I regret trying to keep it all quiet. I had done nothing wrong, but I was positively petrified of them coming in the middle of the night and taking it. It was a Friday night and there would be no way of telling anyone what was going on until Tuesday, due to the May Bank Holiday. All I was trying to do was bring awareness of the need for single-sex wards and instead I was made to feel absolutely petrified for my safety.

Mixed wards need to go. Neither Thames Ward or Trent Ward are safe for any patients. But Barnet is not the only Trust out there ruining people’s lives with these archaic wards. My dear friend (@allyc375 on Twitter) has been suffering terribly at the hands of a neighbouring London Trust due to the mixed-sex environment. Ally has been brave enough to live tweet about this experience and has just written a blog post which sums up the feelings of so many women on these wards, the link to which is https://allywritesblog.wordpress.com/2019/06/28/back-to-bedlam/

Please please take a moment to check out and sign my campaign – I ask for you to share it with whoever you can. This is so important to the lives of hundreds, even thousands of patients being placed in these situations. We need safe spaces to recover and this cannot happen with the current state of psychiatric care. The link again is https://petition.parliament.uk/petitions/260312

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Published by Rivkah

Hi, I am Rivkah and I am 29. I have a law degree with the open university, have a number of pets and also struggle with mental illness.
Follow me on my journey fighting for single sex wards, better community care and more understanding of autism and many other mental health conditions.
Thank you for reading.
Rivkah x
View all posts by Rivkah

Camden and Islington NHS Foundation Trust – another bordering London Trust to @AllyC375′ s home trust- don’t have a single female inpatient bed in the acute care pathway, outside of PICU ,which takes from the whole region . Not one. For a population of approx 250,000 women across the 2 boroughs.

The ONLY female 12 bedded ward is technically a rehabilitation ward and not an assessment ward – all of which are mixed with appalling accounts of men being allowed access to women pts. Both male pts and male staff. To get a bed in the female ward a professional, usually on the acute assessment wards, has to recommend a transfer.

Some women are able to assert their needs but even then are often ignored. Most women acutely mentally unwell aren’t able to assert. And whilst the website talks about women pts being able to choose same gender doctors and nurses if they get to the women only ward, it doesn’t mean these needs will be met. The reality is a million miles away from the rhetoric and PR.

In fact, recently BOTH consultants ON THE ONLY FEMALE WARD WERE MALE. EVERY woman on that ward is allocated male nurses at some point in stay. Including rape victims. Including where they have experienced sexual assault in a ward setting. Showing a total lack of commitment to the trauma focussed approach which as a term has now been hijacked . Where it is publicly claimed the ward is there to provide a safe sanctuary for women.

The same Trust states that to meet women’s needs it has an all female crisis house with all female staff. Which is laudable until you realise that they do not take women who are high risk, they don’t take women who don’t fit in to the talking model of care offered and they take very very few women with a primary psychosis diagnosis. So, in fact, very very few women get considered let alone referred or accepted. It is not an alternative to having all female acute admission wards.

I haven’t once been offered referral during multiple hospital admissions and sections. Most women didn’t even know it was an option. Most women admitted under section spend the entire section on a mixed ward.

Mixed wards are unsafe. Crisis houses here now no longer state they are an alternative to hospital because they are not as arent locked and have no holding powers under the mental health act. So by definition can’t take women at point of section. Leaving NO female commissioned beds for acute admissions. NONE.

Maybe the local CCGs and NHS England should take note of what women are telling them. Is it really too much to ask of the NHS for sexual safety when acutely unwell and vulnerable?